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Advisory Council July 2017 Meeting Presentation: Many Challenges of Alzheimer's Disease

Friday, July 28, 2017

Printer Friendly Version in PDF Format (5 PDF pages)

 

"The Many Challenges of Alzheimer's Disease"

Eliezer Masliah, M.D.
Director, Division of Neuroscience,
National Institute on Aging, NIH

Prevalence of Dementia in the U.S.

Line chart.
Hebert, LE et al. (2013) Neurology 80(19):1778-83.
Hebert, LE et al. (2003) Arch Neurol 60(8):1119-22.

Global Scale of Dementia

The 46.8 million worldwide cases of dementia will almost double every 20 years to 131.5 million by 2015

ADI. World Alzheimer Report 2015. The Global Impact of Dementia. An Analysis of Prevalence, Incidence, Cost and Trends. London; 2015.

Incidence of Dementia over Three Decades in the Framingham Heart Study

Screen shot of the New England Journal of Medicine.

The 5-year age-/sex-adjusted cumulative hazard rates for dementia were:

  • 3.6/100 persons -- 1st epoch (late 1970s - early 1980s)
  • 2.8/100 persons -- 2nd epoch (late 1980s - early 1990s)
  • 2.2/100 persons -- 3rd epoch (late 1990s - early 2000s)
  • 2.0/100 persons -- 4th epoch (late 2000s - early 2010s)

Relative to the incidence during the first epoch, incidence declined by 22%, 38%, and 44% during the 2nd, 3rd, and 4th epochs

Satizabal, CL et al. NEJM (2016) 374(6):523-32

The Growing Cost of Dementia

Dementia costs the US about $200 billion per year. Half that amount is the value of unpaid care provided by family members.

From NIA Health and Retirement Study data

Bar chart.
Hurd, MD et al. (2013) NEJM 368(14):1326-1334.

The Burden of Health Care Costs for Patients With Dementia in the Last 5 Years of Life

Bar charts.
Kelley, A. S., et al. (2015). Ann Intern Med 163(10):729-736.

Out-of-pocket expenditures were slightly lower for married decedents with dementia than for unmarried decedents, but the costs of informal care were more than double for married women in the dementia group

The Burden of Health Care Costs for Patients With Dementia in the Last 5 Years of Life

Bar charts.
Kelley, A. S., et al. (2015). Ann Intern Med 163(10):729-736.

Risk of Alzheimer's Disease by Age in 2017

Bar chart.
Adapted from Hebert, L et al. (2013) Neurology; 80:1778-1783.

ALZHEIMER'S DISEASE RISKS & PROJECTIONS USING MULTI-STATE MODELS WITH BIOMARKERS

R21AG055361 (Brookmeyer, PI)

  • GOALS
    • Forecast pre-clinical and clinical Alzheimer's disease in the U.S.
    • Evaluate potential impact of primary and secondary prevention interventions on future disease burden
    • Determine lifetime risks of AD based on biomarker screening
  • PUBLIC HEALTH RELEVANCE
    • The project synthesizes new biomarker evidence about preclinical AD into a unifying multi-state model for application to clinical practice and public health.

July 28, 2017 -- Advisory Council Meeting #25

The meeting was held on Friday, January 26, 2018, in Washington, DC. The Research Subcommittee took charge of this meeting's theme, focusing on the process from targets to treatments. The Council heard speakers on the preclinical pipeline, the clinical trial pipeline, and the industry perspective. The meeting also included discussion of a driver diagram to guide the Council's future work, updates and a report from the October Care Summit, and federal workgroup updates. Material available from this meeting is listed below and is also available at https://aspe.hhs.gov/advisory-council-alzheimers-research-care-and-services-meetings#Jan2018.

Comments and questions, or alerts to broken links, should be sent to napa@hhs.gov.

 

General Information

 

Presentation Slides

 

Videos

  • Welcome thru Clinical Care -- [Video]

  • LTSS Research -- [Video]

  • Public Comments thru Federal Workgroup Updates -- [Video]

  • Recommendations thru Adjourn -- [Video]